Nurse Case Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Build collaborative relationships and serve as a liaison among clients, patients, employers, providers, and attorneys.

• Evaluate, coordinate, implement, monitor, and assess care plans for individuals who are injured or disabled.

• Utilize knowledge of medical necessity, care appropriateness, and managed care principles.

• Advocate for quality, cost-effective care across the health continuum.

• Assist injured or disabled individuals in returning to their optimal level of work and functioning.

• Document savings related to cases.

• Record the ongoing progress of case management activities.

• Keep well-organized files containing clinical documentation of interactions with all parties for each claim.

• Assess the severity of injuries, extent of disabilities, treatment plans, functional abilities, and physical job requirements.

• Develop return-to-work strategies and plans to manage future medical exposure.

• Oversee all facets of patient care for high-risk individuals.

• Assess patients, guide treatment plans, discuss claims, benefits, and eligibility, and coordinate resources with patients, families, and healthcare professionals.

⛳️ Requirements

• An RN License, preferably from a compact state.

• A California RN license is a plus.

• Full-time position – 9:00 AM CST to 5:30 PM CST, with flexibility based on jurisdiction.

• Strong computer skills are essential – proficiency in Microsoft Suite (Outlook, Excel, Word, etc.).

• A minimum of 3 years of TCM experience is preferred.

• Background in Workers’ Compensation or Disability Management.

• Capacity to maintain confidentiality of all information, policies, and procedures.

• Ability to prioritize tasks and work independently as well as in a team setting.

• Proven sensitivity to culturally diverse individuals and situations.

• Strong time management, organizational, and prioritization skills.

• Knowledge of utilization management, case management, and healthcare delivered throughout the health continuum.

• Excellent verbal and written communication skills with a strong emphasis on customer service.

• Ability to collect data, compile information, and prepare summary reports.

• Strong interpersonal and conflict resolution capabilities.

• Experience in a fast-paced, multi-faceted work environment.

• Demonstrated persistence and strong attention to detail.

• Ability to remain calm in stressful situations.

• BSN, CCM, and/or other insurance/workers’ compensation certifications are advantageous.

• Associate degree required.

🏝️ Benefits

• Competitive base salary.

• Profit sharing opportunities.

• 401k matching program.

• Generous time off policies.

• Opportunities for career advancement.

• A relaxed, yet vibrant work environment.

• Recognized as a Top Workplace in the healthcare sector for 2023.